Using and Undertstanding Your Fertility Medication
Whether you are undergoing in vitro fertilization or simply trying to boost ovulation prior to intrauterine insemination, fertility drugs are probably part of your treatment plan. It is important to understand how these medications work, what effects they can have, and how to administer them properly. The following types of fertility medications are commonly used to help overcome the obstacles of achieving pregnancy:
Usually the first type of fertility medication administered to patients because of its low impact on the body and minimal side effects, clomiphene citrate, commonly known as Clomid®, works by mimicking the chemical structure of estrogen. When the body's endocrine system senses an increase in estrogen, it responds by producing more follicle stimulating hormone (FSH). This triggers the development of follicles and the ripening of the eggs within.
Side effects of clomiphene citrate are mild and may include bloating, achiness, and mood swings. There is a risk of a multiple pregnancy, but it is less than the risk associated with other types of fertility medication.
Gonadotropins, such as Bravelle®, Follistim®, or Gonal-f®, are a family of fertility medications that replicate or contain follicle stimulating hormone (FSH). Unlike clomiphene citrate, which induces the body to produce more of its own FSH, these drugs have a direct effect on the ovaries, stimulating multiple follicle development. An additional medication will need to be administered to trigger the final maturation and release of the eggs.
Gonadotropins are commonly used during IVF treatment to maximize the number of eggs that can be collected for fertilization. They can also be administered to induce follicular development if clomiphene citrate has been ineffective.
Side effects of this type of fertility medication may include bloating, weight gain, and abdominal soreness. There is also an increased risk of a multiple pregnancy and some potential for ovarian hyperstimulation syndrome (OHSS).
Human Chronic Gonadotropin
Lutenizing hormone (LH) is normally released at the end of the oocyte maturation process to complete the ripening of the egg and cause it to be released from the ovary. In a stimulated or controlled cycle, however, this hormone will not be released by the body, so it must be introduced.
Human chorionic gonadotropin (hCG), labeled as the fertility medication Ovidrel®, is the most commonly used LH simulator. It is given in a single injection at the end of an ovulation induction cycle and should be followed within 24 to 48 hours by artificial insemination, intercourse, or egg retrieval for IVF. Because hCG is the hormone that is detected by at-home pregnancy tests, it is possible to have a false positive after receiving an injection of this fertility medication. Only a laboratory blood test that measures the quantity of hCG in a patient's system can be considered an accurate detection of pregnancy with this type of treatment.
Human Menopausel Gonadotropin
Human menopausal gonadotropin (hMG), packaged as Repronex® or Menopur®, contains both follicle stimulating hormone (FSH) and lutenizing hormone (LH). It may be used to induce follicle development and ovulation instead of the typical gonadotropin and hCG treatment.
In a natural cycle, once ovulation has taken place, the empty follicle (known as the corpus luteum) begins to release progesterone into the system. This helps to thicken the uterine lining in preparation for implantation and provides support for the early embryo, should pregnancy occur.
When a course of fertility medication is followed by an egg retrieval procedure, the corpous luteum does not provide the necessary progesterone. It is therefore necessary to give supplemental progesterone after the egg retrieval until it is determined that pregnancy has not occurred or until a pregnancy is established and the body begins producing its own progesterone.
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